Amblyopia Treatment Knowledge Cognition of Iranian Practitioners in 2012.

Background: Amblyopia is considered as one of the most prevalent vision problems in pediatrics age (1-5%). Recently, new methods in amblyopia treatment were reported in Amblyopia Treatment Study (ATS’).The objective of this study was to recognize amblyopia treatment knowledge of Iranian ophthalmologists and optometrists which are responsible for amblyopia treatment in our and other countries.Materials and Methods: This cross sectional study was performed during the Iranian Society of Ophthalmology annual meeting in Tehran in 2012 through questionnaire containing demographic information and 20 closed-answer questions based on ATS results. The questions were classified into seven categories and the sum of correct scores was 100. Optometrists and pediatric ophthalmologists were considered as the group 1 (153 participants), other practitioners (general ophthalmologists and other subspecialists) were regarded as the group 2 (256 participants). Criteria for inadequate, fair and good knowledge were considered by scores of < 50, 50 to 70, and >70 respectively.Results: Overall, 409 out of a total of 600 questionnaires were completed (response rate: 68.1%).  Mean scores of the group 1 were significantly higher than the group 2 in all 7 categories of questions and in 5 of them the differences were statistically significant. The worst and best scores were related to prescription of atropine (12%) and visual acuity improvement with glasses alone (93%), respectively. Scores for other questions were about 50%. There was no relationship between practice status and the number of referral amblyopic cases per week with the level of knowledge. In all categories except prescription of Atropine and recurrence, mean scores of females were more than the male participants.Conclusion: knowledge about amblyopia therapy seems to be overall inadequate and should be improved by more education. We suggest paying more attention to new modified methods of amblyopia treatment and increased discussion of such method in annual and CME meetings

"Planning eye health services in Varamin district, Iran: a cross-sectional study".

BACKGROUND: A recent survey of avoidable blindness in Varamin District, Iran, identified moderately high levels of visual impairment (10%) and blindness (1.5%) in people >50 years. This study aimed to define current provision, identify gaps and suggest practical solutions for improving eye health services in this area. METHODS: The World Health Organization (WHO) framework for analyzing health systems has several key components: service delivery, health workforce, information system, medical products and technologies, financing, and governance. We used this structure to investigate the strengths and weaknesses of the eye health system in Varamin. All public and private eye care facilities and a random selection of primary health care (PHC) units were assessed using semi-structured researcher-administered questionnaires. RESULTS: Varamin has 16 ophthalmic clinics, including two secondary hospitals that provide cataract surgery. There were ten ophthalmologists (1:68,000 population), two ophthalmic nurses and five optometrists working in Varamin district. There were no eye care social or community workers, ophthalmic counsellors, low vision rehabilitation staff. Although the Vision 2020 target for ophthalmologists has been met, numbers of other eye care staff were insufficient. The majority of patients travel to Tehran for surgery. The recent survey identified cataract as the leading cause of blindness, despite the availability of surgical services in the district and high health insurance coverage. Poor awareness is a major barrier. No units had a written blindness prevention plan, formal referral pathways or sufficient eye health promotion activities. Only one of the PHC units referred people with diabetes for retinal examination. There is partial integration between eye care services and the general health system particularly for prevention of childhood blindness: chemo-prophylaxis for ophthalmia neonatorum, school vision tests, measles immunization and Vitamin A supplementation. CONCLUSIONS: This analysis demonstrated the need for better integration between eye care services and the general health system, local planning for prevention of blindness, an information system, a better staff mix and health education to increase community awareness and service uptake. There is the capacity to deliver far more surgery locally. All aspects of a health system need to be developed to deliver comprehensive and efficient eye care

A possible role for LTBP2 in the etiology of primary angle closure glaucoma

Purpose: To assess the association of LTBP2 mutations with primary angle closure glaucoma (PACG). Methods: We studied 54 unrelated patients with PACG and one individual with pseudoexfoliation accompanied with angle closure glaucoma; these consisted of 28 female and 27 male subjects aged 27 to 82 (mean, 63) years. The 36 exons and flanking intronic sequences of LTBP2 in all patients were amplified by PCR and sequenced by the Sanger protocol. The sequences were compared to LTBP2 reference sequences. A total of 100 to 400 controls aged at least 60 years old were screened for various variations. Results: Out of 24 observed sequence variations, ten were in amino acid coding regions; of these four created synonymous codons while six caused amino acid changes. Based on allele frequencies, biochemical parameters, absence in control individuals, evolutionary conservation of affected amino acids, and bioinformatic predictions on the effects on protein function, it was concluded that only two mutations causing p. Gln1417Arg and p. Gly1660Trp may contribute to PACG. The p. Gly1660Trp mutation was observed in a patient with both PACG and PEX syndrome. P. Gln1417Arg had previously been reported only in a subject with POAG. Conclusion: LTBP2 may contribute to PACG. This finding emphasizes that there may be an overlap in the etiology of various forms of glaucoma and the overlaps likely contribute to common features in various forms of glaucoma